Guidance

I am having a lot of anxiety over a recent encounter and I wanted to get you assessment on my risk.

I am a man...I had protected vaginal and unprotected oral (received) with multiple (2) csw's in Hong Kong about 5 weeks ago. Post exposure I started doxycline for anti-malarial protection (am traveling/working in South Asia and was belated told to use for malaria prevention ).

I have not had any discharge or other symptoms that I am aware of...

My anxiety is based on the fact that I will be meeting my significant other in a few days and I am worried about exposing her. I will not be able to get a screening before meeting her. Should I be concerned and look for a way to avoid sexual contact?

It would seem my main risk would be asymptomatic ghonnerria? Clearly I would like to get tested but until then I need to manage risk. Avoiding contact will put a strain on the relationship (as would the truth, unfortunately)

Welcome to our Forum. I'll try to help. the exposures you list are rather low risk. Most commercial sex workers do not have STDs, even those who do rarely have oral infections, and most exposures to infected persons do not lead to infection. In your case, since your vaginal sex was condom protected your only risk was from receipt of oral sex.

The major STDs of concern for persons receiving oral sex are gonorrhea and nongonococcal urethritis. The doxycycline you are taking is recommended therapy for NGU and is active against many (but not all) strains of gonorrhea. NGU should not be a concern. Further, with regard to gonorrhea, the antibiotics would not only cure it if present but, if you were taking it when you were exposed, it would also reduce your risk of becoming infected.

Since you are asymptomatic and most gonorrhea does cause symptoms, as well as considering both the sorts of exposure you mention and that you were taking antibiotics at the time, your risk of any STD from the exposures is quite low. Is it zero, no, but the likelihood of infection in your case is certainly less than 1 in 1000 and probably lower than that. Testing is the best way to be sure but if you cannot arrange for testing, the risk that you are infected and will infect your significant other is quite low.

I hope this guidance helps. I see you have posted the same question on the International Forum and anticipate that you will get a similar assessment from them. EWH

Certainly CSWs are somewhat more likely to be infected than many peole although having an STD is bad for business and hence most CSWs take precautions and are checked regularly. In general, your risk for STD may be higher picking up someone who is has many other partners from a bar for a one-night stand than from having sex with a CSW.

And no, my overall assessment does not change given the change in timing of the doxycycline.

The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.